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City of Santa A 1 <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes No <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />COTC Office Use Only <br />City of Santa Ana <br />ti,+1O 0 2 2621 <br />Clerk of the CouncJ <br />No. A-2020-138 was completed on �� 31 LA) and final payment has been made. <br />(List all amendments. Use space below if needed.) ✓� /1 <br />Department: �'Y—t--�c <br />'Pr I Ad Vie (VA <br />Phone/Ext.: 5�� Jr1+ <br />Signature: a )1`11(k , ("LlfA —0 <br />Date: -71 1bi <br />iaagreementsVormsVorrn - agreement termination form_goldenred.doc <br />